Osteoarthritis | Evaluation Of Efficacy And Safety Of Norspan In Moderate To Severe Pain Due To Osteoarthritis, Rheumatoid Arthritis, Joint/Muscle Pain
Osteoarthritis research study
What is the primary objective of this study?
The purpose of this study is to assess the efficacy of the buprenorphine transdermal patch (Norspan® or Sovenor® transdermal patch) in patients with chronic non-malignant pain of moderate to severe intensity due to osteoarthritis, rheumatoid arthritis, lower back pain and joint/muscle pain, who are not adequately responding to non-opioid painkillers.
Who is eligible to participate?
Inclusion Criteria: 1. Males and females aged 18-80 years (both inclusive) at the time of recruitment. 2. Clinical diagnosis of osteoarthritis, rheumatoid arthritis, lower back pain or joint / muscle pain. 3. Having non-malignant pain of moderate or severe intensity requiring an opioid for adequate analgesia (according to local label of Norspan® or Sovenor®). This is to be determined using BS-11 scores, where the cut-off point is ≥4. 4. Patients with chronic uncontrolled pain and is assessed to require opioid treatment but have not been treated with opioids (including tramadol, morphine etc.) within 4 weeks or more before study entry. Exclusion Criteria: 1. Pregnant and lactating females. 2. Patients with chronic condition(s), in addition to osteoarthritis, that require(s) frequent analgesic treatment (e.g. frequent headaches, frequent migraine, and gout). 3. Patients who are awaiting a scheduled operation or other surgical procedure during study period or 3 months or less post-operative. 4. Prior history of being on opioids in the preceding 1 month prior to the study for the management of chronic non-malignant pain. 5. Prior history of buprenorphine transdermal system use. 6. Patients with history of allergic reactions against paracetamol/ acetaminophen, NSAIDs and/or opioids. 7. Patients with allergies or other contraindications to transdermal systems or patch adhesives. 8. Patients with dermatological disorders who may have problems applying patch or rotating patch placement area. 9. Patients with cancer (except for basal cell carcinoma) or history of cancer who have been diagnosed within five years prior to the first study visit (except for treated basal cell carcinoma). 10. Patients with conditions such as brain tumour, brain injury or raised intracranial pressure. 11. Patients with history of psychiatric disorder, uncontrollable epilepsy, untreated depression or other psychiatric disorders of a type that would make participation in the study an unacceptable risk to the patient. 12. Patients with any conditions causing poor cognitive function as assessed by the participating physician. 13. Patients with history of alcohol and drug abuse or patients who have demonstrated behaviour that suggests a dependency or drug abuse. 14. Patients currently taking hypnotics or other central nervous system depressants that may pose a risk of additional central nervous system depression with study medication. 15. Patients who are currently being administered monoamine oxidase inhibitors (MAOIs) or have taken MAOIs within 2 weeks before screening. 16. Patients requiring dose titration of adjuvant analgesics i.e. antidepressants (e.g. amitriptyline, amoxapine, clomipramine, selective serotonin re-uptake inhibitors (SSRIs)) and anticonvulsants (e.g. gabapentin, pregabalin). Patients will be allowed to enter the study as long as they are on the stable doses of adjuvant analgesics at screening and do not have dose adjustments during the study. 17. Patients who have received steroid treatment (intra-articular, intramuscular, oral, intravenous, epidural or other corticosteroid injections) within 6 weeks prior to clinical study or planned steroid treatment during the clinical study period. 18. Patients who have to use heating facility (examples: heating lamp, electric blanket, sauna, warm compresses, heated saline baths, etc.). 19. Patients who cannot or do not wish to remove hair growing at body surface where the patch can be placed. 20. Patients who are currently on disability claims or in the process of applying for disability claims. 21. Patients at child-bearing age who are planning to conceive a child during the study period and are not practicing adequate contraception. 22. Patients with known severe hepatic impairment as determined by liver function test within the past one year. 23. Patients who are currently in or have participated in other clinical trials within the last 30 days prior to study recruitment.
Which medical condition, disease, disorder, syndrome, illness, or injury is researched?
Lower Back Pain
Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.
Drug:Buprenorphine transdermal patchPlease see Arm Description.
Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.
Buprenorphine transdermal patchSubjects will be on either 5mg, 10mg, 15mg, 20mg, 25mg, 30mg or 40mg doses for 17 weeks. Dose titration will occur every week for the first 6 weeks, and will be maintained for the next 11 weeks.
Start Date: June 2013
Completed Date: January 2015
Phase: Phase 4
Primary Outcome: Efficacy According to BS-11 Pain Score Reduction
Secondary Outcome: Secondary Efficacy Outcome Determined by Change in Percentage of Subjects Who Met Criteria on EQ5D-3L Quality of Life Questionnaire From Pre- to Post-intervention
Study sponsors, principal investigator, and references
Lead Sponsor: Mundipharma Pte Ltd.
Collaborator: Mundipharma Korea Ltd